title: Neuropsychological functions and quality of life in survived patients with intracranial germ cell tumors after treatment.
abstract: BACKGROUND
  The notable survival chances of intracranial germ cell tumors (icGCTs) lead to a rising concern over long-term neurocognitive outcome. Yet, prior evidence related to this issue fails to provide a comprehensive examination of the effects of tumor location and radiotherapy. We attempt to explore their impacts on the neuropsychological functions and life quality in children with icGCT after multimodality treatments.
  
  
  METHODS
  A retrospective review of 56 patients diagnosed with icGCTs at age <20 and treated at the Taipei Veterans General Hospital was provided. Intelligence, memory, visual organization, attention, and executive function were assessed by neurocognitive tests; adaptation to life, emotional and behavioral changes, interpersonal relationships, and impact on the family were evaluated by parent-report instruments. Effects of tumor locations (germinomas and nongerminomatous malignant germ cell tumors in the pineal, suprasellar, and basal ganglia) and irradiation on these measurements were examined.
  
  
  RESULTS
  Patients with tumors in the basal ganglia region had lower full-scale IQs than those with tumors in the pineal or suprasellar regions. Subscores of intelligence scale and short-term retention of verbal and visual stimuli showed evident group differences, as did the quality of life and adaptive skills, particularly in psychosocial domains. Patients treated with whole-ventricular irradiation had better outcomes. Extensive irradiation field and high irradiation dosage influenced intellectual functions, concept crystallization, executive function, and memory.
  
  
  CONCLUSIONS
  Tumor location and irradiation field/dosage appear to be the crucial factors related to certain neuropsychological, emotional, and behavioral dysfunctions that in turn alter the quality of life in children with icGCTs who survive after treatment.
authors.affiliation: Corresponding Author: Tai-Tong Wong, MD, Department of Surgery, Cheng Hsin General Hospital. No.45, Cheng Hsin St., Pei-Tou, Taipei 112, Taiwan. ttwong@vghtpe.gov.tw.
authors.forename: Shih-Yuan
authors.initials: SY
authors.lastname: Liang
authors.forename: Tsui-Fen
authors.initials: TF
authors.lastname: Yang
authors.forename: Yi-Wei
authors.initials: YW
authors.lastname: Chen
authors.forename: Muh-Lii
authors.initials: ML
authors.lastname: Liang
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Chen
authors.forename: Kai-Ping
authors.initials: KP
authors.lastname: Chang
authors.forename: Ian-Kai
authors.initials: IK
authors.lastname: Shan
authors.forename: Ying-Sheue
authors.initials: YS
authors.lastname: Chen
authors.forename: Tai-Tong
authors.initials: TT
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008606:Mental Processes / Q000502:physiology; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D055815:Young Adult
keywords: basal ganglia; intracranial germ cell tumors; neurocognitive functions; quality of life; whole ventri-cular irradiation